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Fulltext Patients' willingness to pay for their drugs in primary care clinics in an urbanized setting in Malaysia: a guide on drug charges implementation

Wan Puteh SE, Ahmad SNA, Aizuddin AN, Zainal R, Ismail R

Asia Pac Fam Med, 2017;16:5.
PMID: 28392749 DOI: 10.1186/s12930-017-0035-5

BACKGROUND: Malaysia is an upper middle income country that provides subsidized healthcare to ensure universal coverage to its citizens. The challenge of escalating health care cost occurs in most countries, including Malaysia due to increase in disease prevalence, which induced an escalation in drug expenditure. In 2009, the Ministry of Health has allocated up to Malaysian Ringgit (MYR) 1.402 billion (approximately USD 390 million) on subsidised drugs. This study was conducted to measure patients' willingness to pay (WTP) for treatment of chronic condition or acute illnesses, in an urbanized population.
METHODS: A cross-sectional study, through face-to-face interview was conducted in an urban state in 2012-2013. Systematic random sampling of 324 patients was selected from a list of patients attending ten public primary cares with Family Medicine Specialist service. Patients were asked using a bidding technique of maximum amount (in MYR) if they are WTP for chronic or acute illnesses.
RESULTS: Patients are mostly young, female, of lower education and lower income. A total of 234 respondents (72.2%) were not willing to pay for drug charges. WTP for drugs either for chronic or acute illness were at low at median of MYR10 per visit (USD 3.8). Bivariate analysis showed that lower numbers of dependent children (≤3), higher personal and household income are associated with WTP. Multivariate analysis showed only number of dependent children (≤3) as significant (p = 0.009; 95% CI 1.27-5.44) predictor to drugs' WTP.
CONCLUSION: The result indicates that primary care patients have low WTP for drugs, either for chronic condition or acute illness. Citizens are comfortable in the comfort zone whereby health services are highly subsidized through universal coverage. Hence, there is a resistance to pay for drugs.

Matched MeSH terms: Multivariate Analysis
Parental smoking status, stress, anxiety, and depression are associated with susceptibility to smoking among non-smoking school adolescents in Malaysia

Lim KH, Chong Z, Khoo YY, Kaur J

Asia Pac J Public Health, 2014 Sep;26(5 Suppl):81S-90S.
PMID: 25038194 DOI: 10.1177/1010539514542426

Susceptibility to smoking is a reliable predictor of smoking initiation. This article describes its prevalence and associated factors among Malaysian school adolescents. Data were obtained from the Global School-Based Student Health Survey (GSHS) 2012, a nationwide representative sample of school adolescents. The overall prevalence of susceptibility to smoking was 6.0% and significantly higher among males (9.5%) compared with females (3.6%). Multivariable analyses revealed that males (adjusted odds ratio [aOR] 3.34, 95% confidence interval [CI] 2.70-4.18) and school adolescents of indigenous Sabahan or Sarawakian descents (aOR 1.62, 95%CI 1.21-2.18) were significantly more likely to be susceptible to smoking. Susceptible school adolescents had a slightly higher likelihood to have symptoms of stress (aOR 1.31, 95% CI 1.02-1.70), anxiety (aOR 1.19, 95% CI 1.01-1.40), depression (aOR 1.56, 95% CI 1.25-1.96), including those whose one or both parents/guardians were smokers (aOR 1.48, 95% CI 1.21-1.82; aOR 2.33, 95% CI 1.22-4.44, respectively). The findings from this study point out the need for proactive measures to reduce smoking initiation among Malaysian adolescents with particular attention toward factors associated with susceptibility to smoking.
Study name: Global School-Based Student Health Survey (GSHS)

Matched MeSH terms: Multivariate Analysis
Outcomes and appropriateness of management of nosocomial Acinetobacter bloodstream infections at a teaching hospital in northeastern Malaysia

Deris ZZ, Harun A, Shafei MN, Rahman RA, Johari MR

Southeast Asian J. Trop. Med. Public Health, 2009 Jan;40(1):140-7.
PMID: 19323046

Acinetobacter spp is a known nosocomial pathogen causing a wide range of clinical diseases such as pneumonia, wound infection and bloodstream infections (BSI). The clinical outcomes of acinetobacter BSI were determined by a 1:1 case control study involving 58 confirmed cases of acinetobacter BSI who were compared to other gram-negative infections. The crude mortality of acinetobacter BSI was 47.2%, which was significantly greater than other gram-negative BSI (OR 1.89, 95% CI 1.10-3.24) but there were no significant differences in attributed mortality between the two groups. We found that patients treated in intensive care units (ICU), who had longer ICU stays, who presented with shock or coagulopathy, had prior exposure to carbapenems, had mechanical ventilation, were on a ventilator for longer periods, had a nasogastric tube, had an arterial catheter or had parenteral nutrition at a significantly greater risk of mortality due to acinetobacter BSI. Patients presenting with septic shock (OR 17.95, 95% CI 3.36-95.84) or having a central venous catheter (OR 12.48, 95% CI 1.09-142.68) were independently at higher risk for mortality. Appropriateness of therapy reduced the mortality attributes of acinetobacter BSI (OR 0.197, 95% CI 0.040-0.967) but did not significantly reduce crude mortality in acinetobacter BSI patients. This study shows the importance of preventing acinetobacter BSI and the appropriate use of antimicrobial agents to reduce mortality.

Matched MeSH terms: Multivariate Analysis
Outcome of children with traumatic brain injury in rural Malaysia

Kumaraswamy N, Naziah A, Abdullah J, Ariff MMed AR, Abdullah MR, Ghazaime G

J Clin Neurosci, 2002 May;9(3):251-5.
PMID: 12093129

Malaysia had the second highest crude accident rate in the world until 1998. Most children who were involved in these road traffic accidents required intensive neurosurgical care management. We report a prospective study on 36 paediatric neurotrauma patients in rural North East West Malaysia who underwent uniform intensive therapy and were subsequently followed up over a period of 2 years. The modified paediatric Glasgow Coma Scale with support of the revised Wechlser Intelligence Scale for children was used to test the outcome of these children over a period of two years. All patients were managed aggressively in our intensive care as well as our high dependency units. Our results indicate that improvement in outcome is seen after a six month period. Midline shift, duration of coma and duration of transport were found to be significant variables associated with bad outcome. Other variables i.e. age, sex, Glasgow Coma Scale on admission and on site, and lesions of the dominant lobe were not found to be associated with good outcome in these patients.

Matched MeSH terms: Multivariate Analysis
Outcome of children with different accessibility to tertiary pediatric intensive care in a developing country--a prospective cohort study

Goh AY, Abdel-Latif Mel-A, Lum LC, Abu-Bakar MN

Intensive Care Med, 2003 Jan;29(1):97-102.
PMID: 12528029 DOI: 10.1007/s00134-002-1534-9

Objective: Lack of direct access to tertiary pediatric intensive care services in rural hospitals may be associated with poorer outcome among critically ill children. Inter-hospital transport by non-specialized teams may also lead to increased morbidity and even mortality. We therefore studied the outcome of children with different accessibility to tertiary pediatric care in Malaysia.

Methods: We prospectively compared the Pediatric Risk of Mortality (PRISM II) adjusted standardized mortality ratio (SMR), unanticipated deaths and length of stay of 131 patients transported from rural hospitals (limited access) with 215 transferred from the casualty wards or other in-hospital wards (direct access) to a tertiary pediatric ICU.

Results: The transported patients were younger than the in-hospital patients (median age 1.0 versus 6.0 months, p=0.000) and were more likely to have respiratory diseases. Other baseline characteristics did not differ significantly. Differences in access to tertiary intensive care from community hospitals was associated with an extended median length of stay (4.0 versus 2.0 days, p=0.000) but did not affect SMR (0.92 versus 0.84, rate ratio 1.09, 95% CI 0.57-2.01; p=0.348) or percentage of unexpected deaths (4.8% versus 2.8%, p=0.485). The adjusted odds ratio for mortality (1.7, 95% CI 0.7-4.3) associated with transfer was not statistically significant (p=0.248).

Conclusions: The outcome of critically ill children transferred from community hospitals did not differ from that of those who develop ICU needs in the wards of a tertiary center, despite being transported by non-specialized teams. Outcome was not affected by initial inaccessibility to intensive care if the children finally received care in a tertiary center.

Matched MeSH terms: Multivariate Analysis
Fulltext Optimization of soaking conditions for the production of seaweed (Kappaphycus alverazii) paste using response surface methodology

Siah, W. M., Aminah, A., Ishak, A.

International Food Research Journal, 2014;21(2):471-477.
MyJurnal

The effects of soaking conditions on the quality characteristics of seaweed paste of Kappaphycus alverazii species were studied. Response Surface Methodology (RSM) with a 2-factor, 5-level central composite design (CCD) was conducted to determine the optimum soaking conditions. The interactive effect of dry seaweed: soaking water ratio (X1 = 1: 15-50) and soaking duration (X2 = 30-120 min) on the gel strength (g), whiteness, expansion (%), moisture content (%) and protein content (g/100 g) of the paste were determined. Results showed that the experimental data could be adequately fitted into a second-order polynomial model with multiple regression coefficients (R2) of 0.8141, 0.9245, 0.9118, 0.9113 and 0.9271 for the gel strength, whiteness, expansion, moisture content and protein content, respectively. The gel strength, whiteness, expansion, moisture content and protein content of seaweed paste were dependent on the ratio of dry seaweed to soaking water and also soaking duration. The proposed optimum soaking conditions for the production of seaweed paste is at a ratio of 1:15 (dry seaweed : soaking water) and soaking duration of 117.06 min. Based on the result obtained, the RSM demonstrated a suitable approach for the processing optimization of Kappaphycus alverazii paste.

Matched MeSH terms: Multivariate Analysis
Fulltext Optimization and validation of a method for extraction and quantification of ochratoxin A in black pepper

Jalili, Maryam, Jinap, S.

International Food Research Journal, 2015;22(2):502-509.
MyJurnal

The extraction method for the determination of ochratoxin A (OTA) in black pepper was optimized. The influence of three variables, i.e., type of solvent, solvent-volume-to-sample- size ratio (v/w) and amount of sodium chloride (NaCl) (g), on OTA recovery was evaluated. Analysis of variance was used to compare recovery values obtained from different solvents, and response surface methodology (RSM) was used to determine the optimum amount of NaCl and the solvent-volume-to-sample-size ratio. The concentration of OTA was determined by high-performance liquid chromatography with fluorescence detection. The highest recovery (95.2 %) was obtained when methanol/water (80:20, v/v) was used as the solvent. The RSM results showed that the experimental data could be adequately fitted to a second-order polynomial model with multiple regression coefficients (R2) of 0.962. The optimum amount of NaCl was determined to be 3 g, whereas the optimum solvent-volume-to-sample-size ratio (v/w) was found to be 4. The proposed method was applied to 20 samples, and the presence of OTA was found in 8 (40%) samples ranging from 0.11 to 3.16 ng g-1.

Matched MeSH terms: Multivariate Analysis
Old World screwworm fly, Chrysomya bezziana, occurs as two geographical races

Hall MJ, Edge W, Testa JM, Adams ZJ, Ready PD

Med Vet Entomol, 2001 Dec;15(4):393-402.
PMID: 11776458

A morphological and molecular analysis was undertaken with the objective of identifying markers for geographical populations of Old World screwworm flies, Chrysomya bezziana Villeneuve (Diptera: Calliphoridae). The morphological analysis involved 192 adult flies from 14 countries, and the molecular analysis involved 45 larvae or adults from 14 populations in 11 countries. Principal components and cluster analysis of 10 morphological characters indicated that flies from Papua New Guinea (PNG) were a distinct group and most similar to flies from nearby Asian islands (Java, Sabah). There was poor resolution of other geographical regions, but some support for clustering of flies from Africa or India. Cladistic analysis of mitochondrial DNA sequences gave strong support for recognizing two races of Old World screwworm, one from sub-Saharan Africa and the other from the Gulf region and Asia. This latter race could be further divided into two lineages, i.e. one from mainland Asia (from Iraq to the Malay Peninsula) and the other from two islands of PNG.

Matched MeSH terms: Multivariate Analysis
Odontometric sex variation in Malaysians with application to sex prediction

Khamis MF, Taylor JA, Malik SN, Townsend GC

Forensic Sci Int, 2014 Jan;234:183.e1-7.
PMID: 24128748 DOI: 10.1016/j.forsciint.2013.09.019

Information about the sex of individuals is important for human identification. This study was conducted to quantify classification rates of sex prediction models for Malaysians using odontometric profiles. Mesiodistal (MD) and buccolingual (BL) crown dimensions of the permanent dentition were studied in 400 young adult Malaysians, giving a total of 28 tooth size variables. The sample consisted of three major ethnic groups, the Malays, Chinese and Tamils, since the aim was to assess sex dimorphism in Malaysians as a whole. Results showed that the mesiodistal diameter of the lower canine was the most sexually dimorphic dimension in Malaysian Malays and Tamils. Univariate analyses showed that the magnitude and pattern of sex dimorphism varies between these three ethnic groups, with Malaysian Chinese and Tamils being more dimorphic than the Malaysian Malays. Stepwise discriminant functions were generated bearing in mind their application in practical forensic situations. The range of classification rates was from 70.2% to 78.5% for the composite Malaysian group, and 83.8%, 77.9%, 72.4% for Malaysian Chinese, Malays and Tamils, respectively. The 'Area Under the Receiver Operating Characteristic Curve statistics' indicated good classification rates for three prediction models obtained using a combination of all tooth size variables, mandibular teeth, and mesiodistal dimensions in the composite Malaysian group, and for all tooth size variables in each ethnic group. The present study provides strong support for the value of odontometry as an adjunct scientific method for sex prediction in human identification.

Matched MeSH terms: Multivariate Analysis
Occlusal re-establishment and clinical complications of resin-bonded fixed partial dental prostheses cemented at an increased occlusal vertical dimension: A retrospective study

Lim TW, Ab Ghani SM, Mahmud M

J Prosthet Dent, 2020 Dec 02.
PMID: 33279159 DOI: 10.1016/j.prosdent.2020.06.034

STATEMENT OF PROBLEM: Resin-bonded fixed partial dental prostheses (RBFPDPs) cemented at an increased occlusal vertical dimension (OVD) (the Dahl concept) to create space for a metal retainer remain controversial because of the lack of reported clinical studies. This study evaluated RBFPDPs by applying the Dahl concept.
PURPOSE: The purpose of this retrospective study was to investigate the clinical factors affecting the occlusal re-establishment and short-term complications of RBFPDPs cemented at an increased OVD.
MATERIAL AND METHODS: Occlusal re-establishment and clinical complications were reviewed in 109 participants (155 RBFPDPs) treated at the Faculty of Dentistry, Universiti Teknologi MARA from January 2013 to May 2018. Types of complications and risk factors were assessed from clinical data. Demographic factors, clinical factors, and prosthesis factors were distinguished and their association with occlusal re-establishment analyzed by using multiple regression analysis.
RESULTS: A total of 155 RBFPDPs (42 anterior, 113 posterior) were placed in 109 participants. All achieved occlusal re-establishment, 89.9% complete occlusal re-establishment and 10.1% partial occlusal re-establishment, a minimum of 4 months after the RBFPDPs had been placed at an increased OVD. The design of the metal retainer coverage was found to be a significant factor affecting occlusal re-establishment and decementation (P

Matched MeSH terms: Multivariate Analysis
Fulltext Nurses' knowledge, beliefs and practices regarding the screening and treatment of postpartum depression in maternal and child health clinics: A cross-sectional survey

Kang PS, Mohazmi M, Ng YM, Liew SM

Malays Fam Physician, 2019;14(1):18-25.
PMID: 31289627

Background: Postpartum depression (PPD) affects 10-15% of women worldwide, and screening is recommended by clinical guidelines. In Malaysia, nurses in maternal and child health (MCH) clinics provide postpartum care.

Aim: To determine nurses' level of knowledge, beliefs and practices regarding PPD and factors associated with screening practices.

Methods: A cross-sectional study using universal sampling was conducted on nurses from seven government MCH clinics in Malaysia. Data was collected from March until April 2016 through a self-reported questionnaire. Univariate and multivariate analyses were performed to identify factors associated with having ever performed PPD screening.

Results: Of the 108 nurses, 55.6% scored above the median total knowledge score (17 out of 24 points). Despite a high proportion of nurses believing that they were responsible for PPD screening (72.2%), counselling depressed mothers (72.2%) and referring mothers for further treatment (87.0%), only 64.8% and 51.9% were confident in recognizing PPD and counselling depressed mothers, respectively. Only 25.9% had ever practiced PPD screening, which was associated with beliefs concerning screening taking too much time (adjusted odds ratio [AOR]=0.13, 95% confidence interval [CI]= 0.02-0.74, P=0.022) and that screening is their responsibility (AOR=14.12, 95%CI=1.65-120.75, P=0.016).

Conclusion: More than half of the nurses scored above the median total knowledge score and had positive beliefs towards PPD screening. However, PPD screening practices were poor, and this outcome was associated with their beliefs regarding time and responsibility.

Matched MeSH terms: Multivariate Analysis
Nasopharyngeal carcinoma in Malaysian Chinese: salted fish and other dietary exposures

Armstrong RW, Imrey PB, Lye MS, Armstrong MJ, Yu MC, Sani S

Int J Cancer, 1998 Jul 17;77(2):228-35.
PMID: 9650558 DOI: 10.1002/(SICI)1097-0215(19980717)77:2<228::AID-IJC

We interviewed 282 histologically confirmed cases of nasopharyngeal carcinoma (NPC) in Chinese residents of Selangor and the Federal Territory, Malaysia, and an equal number of Chinese age-, sex-, and length-of-residence-matched controls sampled from the general population. Consumption of 55 dietary items during childhood, and 5 years pre-diagnosis of NPC, was analyzed by univariate and multivariate methods. Four salted preserved foods (fish, leafy vegetables, egg and root), fresh pork/beef organ meats and beer and liquor consumption exhibited strong positive associations, and 4 vegetable/fruit combinations strong negative associations with NPC. Factor analysis and multivariable modeling using estimated factor scores strongly supported separate effects on NPC of vegetables/fruits, salted preserved foods, pork/beef organ meats and beer/liquor consumption. Multivariable modeling associated NPC most clearly with high consumption of salted fish, salted eggs, pork/beef liver and beer and low consumption of Chinese flowering cabbage, oranges/tangerines and shrimp. A strong residual association of social class with NPC remained after adjustment for diet, which is consistent with a substantial role for non-dietary environmental factors.

Matched MeSH terms: Multivariate Analysis
Fulltext Musculoskeletal symptoms risk factors and postural risk analysis of pineapple plantation workers in Johor

Nur Hidayah Rani, Emilia Zainal Abidin, Noor Afifah Ya'acob, Karmegam Karuppiah, Irniza Rasdi

Journal of Occupational Safety and Health, 2016;13(1):17-26.
MyJurnal

Pineapple plantation workers are exposed to strenuous physical activities. This study aims to determine the prevalence
of musculoskeletal symptoms (MSS), analyse the body postural risks related to work tasks and identify relevant MSS risk factors
among pineapple plantation workers. This was a cross-sectional study performed at a pineapple plantation in Johor in 2016. MSS,
information on socio-demographic background and occupational history were collected via structured questionnaires. Identification
and risk assessment of ergonomic hazard and postural risk analysis were performed for a subset of workers. Data were entered into
statistical software and analyse according to relevant objectives. A total of 108 workers participated in this study. The prevalence
of MSS was 87.0% and was highest for the lower back (64.8%). In terms of ergonomic hazards, Harvesting were categorised as a
task with the highest risk. Harvesting was also the task with the highest postural risk. From the multivariate analysis, lower back
pain is mainly contributed by a working tenure of 10 to 25 years (Odds Ratio, OR: 3.90; 95% Confidence Interval, CI 1.05-14.4) and
more than 25 years (OR: 7.45 (95% CI 1.26 to 44.0). Workers who worked more than 7-hour daily have a higher risk for reporting
lower back pain. Pineapple plantation workers are exposed to excessive bending, twisting and carrying of heavy loads that may be
linked to MSS. Effective preventive strategies are required to address MSS in this population in order to minimize risk for subsequent
musculoskeletal disorders.

Matched MeSH terms: Multivariate Analysis
Multivariate statistical techniques for the assessment of seasonal variations in surface water quality of pasture ecosystems

Ajorlo M, Abdullah RB, Yusoff MK, Halim RA, Hanif AH, Willms WD, et al.

Environ Monit Assess, 2013 Oct;185(10):8649-58.
PMID: 23604787 DOI: 10.1007/s10661-013-3201-8

This study investigates the applicability of multivariate statistical techniques including cluster analysis (CA), discriminant analysis (DA), and factor analysis (FA) for the assessment of seasonal variations in the surface water quality of tropical pastures. The study was carried out in the TPU catchment, Kuala Lumpur, Malaysia. The dataset consisted of 1-year monitoring of 14 parameters at six sampling sites. The CA yielded two groups of similarity between the sampling sites, i.e., less polluted (LP) and moderately polluted (MP) at temporal scale. Fecal coliform (FC), NO3, DO, and pH were significantly related to the stream grouping in the dry season, whereas NH3, BOD, Escherichia coli, and FC were significantly related to the stream grouping in the rainy season. The best predictors for distinguishing clusters in temporal scale were FC, NH3, and E. coli, respectively. FC, E. coli, and BOD with strong positive loadings were introduced as the first varifactors in the dry season which indicates the biological source of variability. EC with a strong positive loading and DO with a strong negative loading were introduced as the first varifactors in the rainy season, which represents the physiochemical source of variability. Multivariate statistical techniques were effective analytical techniques for classification and processing of large datasets of water quality and the identification of major sources of water pollution in tropical pastures.

Matched MeSH terms: Multivariate Analysis
Multivariate statistical analysis treatment of DSC thermal properties for animal fat adulteration

Dahimi O, Rahim AA, Abdulkarim SM, Hassan MS, Hashari SB, Mashitoh AS, et al.

Food Chem, 2014 Sep 1;158:132-8.
PMID: 24731324 DOI: 10.1016/j.foodchem.2014.02.087

The adulteration of edible fats is a kind of fraud that impairs the physical and chemical features of the original lipid materials. It has been detected in various food, pharmaceutical and cosmeceutical products. Differential scanning calorimetry (DSC) is the robust thermo-analytical machine that permits to fingerprint the primary crystallisation of triacylglycerols (TAGs) molecules and their transition behaviours. The aims of this study was to assess the cross-contamination caused by lard concentration of 0.5-5% in the mixture systems containing beef tallow (BT) and chicken fat (CF) separately. TAGs species of pure and adulterated lipids in relation to their crystallisation and melting parameters were studied using principal components analysis (PCA). The results showed that by using the heating profiles the discrimination of LD from BT and CF was very clear even at low dose of less than 1%. Same observation was depicted from the crystallisation profiles of BT adulterated by LD doses ranging from 0.1% to 1% and from 2% to 5%, respectively. Furthermore, CF adulterated with LD did not exhibit clear changes on its crystallisation profiles. Consequently, DSC coupled with PCA is one of the techniques that might use to monitor and differentiate the minimum adulteration levels caused by LD in different animal fats.

Matched MeSH terms: Multivariate Analysis
Fulltext Multivariate statistical analysis of antioxidants in dates (Phoenix dactylifera)

Abbas, F.M.A., Foroogh, B., Liong, M.T., Azhar, M.E.

International Food Research Journal, 2008;15(2):193-200.
MyJurnal

Four types of soft dates (SD), three types of semi-dried dates (SDD) and one type of dried dates (DD) were used in this study. The antioxidant activities were assessed using TEAC method (ABTS assay) and the ferric reducing/antioxidant power method (FRAP assay), while total phenolic content (TPC) and total flavonoid content (TFC) were measured using Folin-Ciocalteau and aluminum chloride colorimetric methods. Multivariate analysis of variance (MANOVA), discriminant analysis (DA) and principal component analysis (PCA) were used to analyze the data. MANOVA showed a strong significant difference between the eight types of dates. DA identified the relative contribution of each parameter in distinguishing the dates. DA also identified two functions responsible for discriminating the dates and showed the difference between different types of dates. The first function distinguished DD from other types of dates, whilst the second function discriminated SD and SDD, affording 100% correct assignation. PCA identified only one component responsible for explaining 98.85% of the total variance in antioxidant data. It is suggested that the TEAC method and the quantitative determination of TPC and TFC was suitable for differentiation of dates and quality control.

Matched MeSH terms: Multivariate Analysis
Fulltext Multivariate optimization in the biosynthesis of a triethanolamine (TEA)-based esterquat cationic surfactant using an artificial neural network

Masoumi HR, Kassim A, Basri M, Abdullah DK, Haron MJ

Molecules, 2011 Jun 29;16(7):5538-49.
PMID: 21716175 DOI: 10.3390/molecules16075538

An Artificial Neural Network (ANN) based on the Quick Propagation (QP) algorithm was used in conjunction with an experimental design to optimize the lipase-catalyzed reaction conditions for the preparation of a triethanolamine (TEA)-based esterquat cationic surfactant. Using the best performing ANN, the optimum conditions predicted were an enzyme amount of 4.77 w/w%, reaction time of 24 h, reaction temperature of 61.9 °C, substrate (oleic acid: triethanolamine) molar ratio of 1:1 mole and agitation speed of 480 r.p.m. The relative deviation percentage under these conditions was less than 4%. The optimized method was successfully applied to the synthesis of the TEA-based esterquat cationic surfactant at a 2,000 mL scale. This method represents a more flexible and convenient means for optimizing enzymatic reaction using ANN than has been previously reported by conventional methods.

Matched MeSH terms: Multivariate Analysis*
Multivariate areal analysis of the impact and efficiency of the family planning programme in peninsular Malaysia

Tan Boon Ann

Asia Pac Popul J, 1987 Jun;2(2):45-66.
PMID: 12341280
Matched MeSH terms: Multivariate Analysis*
Multivariate areal analyses of neo-natal mortality in peninsular Malaysia

Tey Nai Peng, Tan Boon Ann, Arshat H

Malays J Reprod Health, 1985 Jun;3(1):46-58.
PMID: 12314427
Matched MeSH terms: Multivariate Analysis*
Multivariate analysis on unilateral cleft lip and palate treatment outcome by EUROCRAN index: A retrospective study

Yew CC, Alam MK, Rahman SA

Int J Pediatr Otorhinolaryngol, 2016 Oct;89:42-9.
PMID: 27619027 DOI: 10.1016/j.ijporl.2016.07.026

OBJECTIVES: This study is to evaluate the dental arch relationship and palatal morphology of unilateral cleft lip and palate patients by using EUROCRAN index, and to assess the factors that affect them using multivariate statistical analysis.
METHOD: A total of one hundred and seven patients from age five to twelve years old with non-syndromic unilateral cleft lip and palate were included in the study. These patients have received cheiloplasty and one stage palatoplasty surgery but yet to receive alveolar bone grafting procedure. Five assessors trained in the use of the EUROCRAN index underwent calibration exercise and ranked the dental arch relationships and palatal morphology of the patients' study models. For intra-rater agreement, the examiners scored the models twice, with two weeks interval in between sessions. Variable factors of the patients were collected and they included gender, site, type and, family history of unilateral cleft lip and palate; absence of lateral incisor on cleft side, cheiloplasty and palatoplasty technique used. Associations between various factors and dental arch relationships were assessed using logistic regression analysis.
RESULT: Dental arch relationship among unilateral cleft lip and palate in local population had relatively worse scoring than other parts of the world. Crude logistics regression analysis did not demonstrate any significant associations among the various socio-demographic factors, cheiloplasty and palatoplasty techniques used with the dental arch relationship outcome.
CONCLUSIONS: This study has limitations that might have affected the results, example: having multiple operators performing the surgeries and the inability to access the influence of underlying genetic predisposed cranio-facial variability. These may have substantial influence on the treatment outcome. The factors that can affect unilateral cleft lip and palate treatment outcome is multifactorial in nature and remained controversial in general.

Matched MeSH terms: Multivariate Analysis

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